<include file="public@header" />
</head>
<style>
</style>
<body>
        <div class="row" style="text-align:center">
            <div class="col-md-12">
                <table class="table table-hover table-bordered">
                    <tbody>
                    <tr ><td colspan="12" style="text-align:center; font-size: 20px; color:#000;font-weight: bold ">济南恭德陵园落葬通知单</td></tr>
                    <tr >
                        <td colspan="11" style="text-align:center; font-size: 16px; color:#000;font-weight: bold ">
                            年        月        日</td>
                        <td >NO：1301330 </td>
                    </tr>
                    <tr>
                        <td rowspan="2">持证人</td>
                        <td rowspan="2"></td>
                        <td rowspan="2">墓 位</td>
                        <td rowspan="">具体位置</td>
                        <td colspan="3"> </td>
                        <td rowspan="">安葬人</td>
                        <td rowspan="2"></td>
                        <td  colspan="3">  男：</td>
                    </tr>
                    <tr>
                        <td >墓位编号</td>
                        <td colspan="3"></td>
                        <td colspan="2"></td>
                        <td  colspan="3">   女：</td>
                    </tr>
                    <tr>
                        <td  rowspan="2" >落葬</td>
                        <td >日期</td>
                        <td colspan="2"></td>
                        <td  colspan="4"> 家 庭 联 系 电 话</td>
                        <td  colspan=""> 火化单</td>
                        <td  colspan="">死亡证明</td>
                        <td  colspan="">碑文情况</td>
                        <td  colspan=""></td>
                    </tr>
                    <tr>
                        <td >时间</td>
                        <td colspan="2"></td>
                        <td  colspan="4">  </td>
                        <td  colspan=" ">  </td>
                        <td  colspan=" ">  </td>
                        <td  colspan=" ">  </td>
                        <td  colspan=" ">  </td>
                    </tr>
                    <tr>
                        <td rowspan="2">交单 时间</td>
                        <td rowspan="2" colspan="3"></td>
                        <td  rowspan="2" colspan="2"> 接单人</td>
                        <td  rowspan="2" colspan="2">  </td>
                        <td  colspan="3"> 墓 穴 </td>
                        <td  colspan="">墓穴状态</td>
                    </tr>
                    <tr>
                        <td  >单穴</td>
                        <td  >双穴</td>
                        <td  >三穴</td>
                        <td  ></td>
                    </tr>
                    <tr>
                        <td > </td>
                        <td colspan="11"></td>
                    </tr>
                    <tr>
                        <td  colspan="2">持证人签字：</td>
                        <td  colspan="2">   </td>
                        <td  colspan="2"> 落葬组负责人签字：</td>
                        <td  colspan="2"> </td>
                        <td  colspan="2"> 经办人：</td>
                        <td  colspan="2">  </td>
                    </tr>

                    </tbody>
                </table>
            </div>
        </div>
<script type="text/javascript" src="__STATIC__/js/admin.js?v={:time()}"></script>

</body>
</html>